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Illinois rates for HCPCS 15121

Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)

Facilitymedian $2,138 · 10th–90th $251–$7,7620%5%10th90th$2,138Professionalmedian $295 · 10th–90th $166–$1,2300%5%10%10th90th$295$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $2,290.87 / $7,762.47
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $1,513.56 / $2,884.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $295.12 / $1,230.27
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $851.14 / $2,290.87